Imaging guidance techniques for percutaneous ablation could be provided by fluoroscopy, US,CT and MR.The choice between them offen depends on the skill and preference of the operator and also the availability.CT can provide accurate three dimensional(3D)anatomical information,contrast enhancement will better delineate the lesion and assess its vascularity and 3D restruction techniques would further highlight the surrounding vascular structure and organs in order to prevent damages during puncture.MSCT is thus eminently suitable for percutaneous tumor ablation guidance procedures,including pure ethanol injection (PEI),microwave coagulation therapy(PMCT),interstitial laser photocoagutation(ILP),radio-frequency(RF), electrochemotherapy(ECHT)and so on.In recent years,CT-guided radioactive seed implantation technique in treating lung tumor,pancreatic cancer and metastasis was reported with good clinical effects of minimal damage and few complications.Some investigators reported that there were no significant differences in the tumor necrosis rate,cumulative recurrence and cumulative survival rate between PEI alone and PEI combined TACE for small tumor,however,combined therapy of PEI and TACE has better efficacy in treatment of tumor larger than 3 cm compared to only one therapeutic technique.Therefore,combination of interventional therapies may be more suitable for treatmemt of larger tumors.(J Intervent Radiol,2007,16:793-795)

Medical imaging is evolving from the traditional morphologic examination to a pattern that combines morphologic and functional examinations that can reflect physiochemical changes at cellular and molecular levels. Functional imaging techniques, including CT perfusion imaging, MR diffusion weighted imaging, MR perfusion imaging and MR spectroscopy, have been drawing increasingly more attention in pathological study of the livers, pancreas, kidneys, prostates and lymph nodes, and the prospect is promising. CT & MR functional imaging combined with morphologic examination is helpful for the diagnosis and differential diagnosis of pathological lesions.

ObjectiveTo establish nude mouse tumor models bearing human pancreatic adenocarcinoma SW1990 cells in multiple sites at different time-points and investigate the feasibiilty of multiple tumor-bearing in these models; then the findings and detection rate of 3.0T magnetic resonance image (MRI) in subcutaneous transplanted tumors was analyzed. Methods A total of 6 BALB/C nude mice were randomized into 3 groups (2 mice per group ).At the 1st,8th,15th day,the mice were injected subcutaneously with the suspension of SW1990 cells at left axilla and right axilla and right groin in sequence.Three weeks later,all the bearing-tumor mice were performed with MRI non-contrast enhanced scanning plus Gd-DTPA enhanced scan and the subcutaneous masses were subjected to pathological analysis.ResultsAll the 6 nude mice were alive during the study and obvious mass was observed in every injected site.The tumor size was positively associated with the grwing time.There were 9 tumors which could be de.ted by noncontrast enhanced MRI scanning and one more tumor was detected by contrast enhanced scanning.2 tumors were not detected,the 2 tumors were located at subcutaneous of right groin,with the shortest growing time,and the major axis of the 2 un-detected tumors was less than 5mm.Despite the MRI findings of the transplanted masses similar to that of human pancreatic adenocarcinoma with bleeding,necrosis,they presented the characteristics of a clear rim,with pseudocapeule sign.All the 12 masses were similar with human pancreatic adenocarcinoma under light microscope.ConclusionsIt is feasible to transplant human pancreatic adenocarcinoma cell at three different subcutaneous sites (injected at three different points of time) in the nude mouse,with a minimal survival time of three weeks.However,routine 3.0T MRI cannot detect the early tumors (growing time within 1 week,major axis ＜5 mm).

Objective To explore the safety and success rate of endovascular intervention in the treatment of Budd-Chiari syndrome. Methods Double balloon-catheters were inserted into proximal and distal of the obstructive segments in inferior vena cava of 18 cases of Budd-Chiari syndrome respectively. The balloon was filled with contrast medium. Perforation in the obstructive segments was done by hard core through a balloon-catheter, using another one as a guide. Results The length of obstructive segments in inferior vena cava ranged from 1.2cm to 8.0cm. In the 18 cases of Budd-Chiari syndrome, 15 obstructive segments were perforated successfully(83.3%), of whom 6 cases were performed by single balloon-catheters with acute pericardial wadding in 1 case and 9 cases by double balloon-catheters without vessels damage and bleeding. Conclusions The membrane perforation induced by double balloon-catheters is a key process of endovascular interventive technique in the treatment of Budd-Chiari syndrome.

Objective To investigate the therapeutic effects of TNF and IL 2 recombinant adenoviruses via intra arterial injection on metastatic liver cancer in rat model. Methods Recombinant adenoviruses harboring hTNF ? or hIL 2 gene were amplified in 293 cells and subjected to titration by the pathogenetic effects on 293 cell. The rats bearing metastatic liver cancer of Walker 256 breast carcinoma were randomly grouped and administered via gastra intestinal artery with hTNF ? recombinant adenoviruses alone, or hIL 2 recombinant adenoviruses alone, or at the dose of 1.0?10 9 pfu/rat. The therapeutic effects were observed including their survival time. Results The prepared recombinant adenoviruses of hTNF ? and hIL 2 were with the titers of 2.0?10 9 pfu/ml and 2.1?10 9 pfu/ml, respectively. 1.0 ?10 9 pfu hTNF was the proper dose. Administration of hTNF ? or hIL 2 recombinant adenoviruses via hepatic artery could extend the survival time of metastatic liver cancer bearing rats, with the better therapeutic effects achieved by combinatorial administration of these two adenoviruses. Conclusion Arterial administration of adenoviruses may be an effective approach to targeted immunogene therapy for cancer.

Objective To investigate the gene transfer efficiency and lasted time in rat organs by hepatic artery injection with LacZ reporter gene recombinant adenoviruses. Methods Seven groups of rats were injected with Ad.LacZ (2?10 9 pfu/ml) and two groups of rats were injected with PBS 1 ml as control separately through gastra intestinal artery, and liver, spleen, lung, and kidney were gotten at 12 hrs, 18 hrs, 72 hrs, 7 day, 14 day, 21 day, and 28day, respectively. X gal staining was used to check up expression of LacZ gene. Results Expression of LacZ gene was detected in liver 12 hrs after injection, but none were done in spleen, lung, and kidney. Up to 21days, LacZ gene expressed in liver, but the gene expression lasted for only 14 days in spleen, lung, and kidney LacZ gene was not detected in the two control groups in all organs at 7 day. Conclusion When recombinant adenovirus was administrated through hepatic artery, the introduced gene expressed preferentially in liver. This result was the basis of intraarterial administration of cytokines gene to treat liver tumor.

Objective To make a curve of dose grads liver signal of superparamagnetic iron oxide (SPIO) in normal rats, to compare lesion to liver contrast noise ratio (C/N) and to assess the ability on MR imaging before and after SPIO injection. Methods Group one: 72 normal SD rats divided into 18 specimen groups at random, underwent MR enhancement with 0,2,5……280 ?mol Fe/kg SPIO respectively after plain scanning. The signal to noise ratio of liver was measured and a curve of dose grads liver signal was made in order to find an appropriate dose for enhancement. Group two: 38 rats with 43 implanted liver adenocarcinomas underwent T 1 and T 2 weighted MR imaging before and after the injection of SPIO agent. Evaluations included enhancing characteristics of the tumors, counting the number of lesions and statistical analysis of quantitative changes in the signal intensity of both lesions and normal liver. Results On SPIO enhanced T 2 weighted and T 1 weighted MR images, the signal intensity of liver was reduced to peripheral noise on the dose of 10 ?mol Fe/kg and 40 ?mol Fe/kg respectively. The highest contrast to noise ratio (C/N) could be acquired on the dose of 20 ?mol Fe/kg on enhanced T 2 weighted MR images; its C/N almost doubled compared with that of enhanced T 1 weighted and unenhanced T 2 weighted MR images. The C/N of unenhanced T 1 weighted MR images was lowest. The number of lesions detected on enhanced MR imaging was the same as that of the pathology, and enhanced MR imaging was superior to unenhanced MR imaging in tumors smaller than 3 mm, of 36.3% escaped detection on unenhanced MR images. Conclusion Good enhancement effect of SPIO on T 1 and T 2 weighted MR imaging could be acquired at the dose of 20 ?mol Fe/kg, its detecting ability approached that of gross pathology, and the best contrast to noise ratio was found on T 2 weighted enhanced MR image.

0.05). The MIP image should be used to select the optimal projection angle and measure the aneurysm, while the SSD image was for reference only. Conclusion SCTA can not only diagnose cerebral aneurysms accurately but also has high directive value in making therapy plan, surgical preparation and endovascular embolization.

Objective To evaluate the feasibility, safety and efficacy of selective portal vein embolization (SPVE) in treatment of liver tumor in rats and to provide the groundwork for its future clinical applications. Methods 24 healthy rats underwent the embolization. Pre and post SPVE portogram and liver chemical profile were obtained. Four rats were sacrificed at 10 min, 7,14, 21 and 28 days respectively following follow up portography. The liver, heart, lungs and kidneys were examined macroscopically and microscopically. Fifteen rats implanted with Walker 256 tumor sized from 3 to 10 mm in liver were scanned with MRI and portography pre SPVE taken. Post SPVE 3 rats were examined with MRI for each group at the same interval as above and the lives were examined microscopically. Results (1) The blood flow to the target portal branches were immediately halted after SPVE. These vessels remained occluded without collateral formation up to 28 days. (2) The liver indexes and BUN level increased after embolization, but returned to normal within 21 d. Macroscopic and microscopic changes were not found in the heart, lungs or kidneys. (3) In the healthy rats, the affected segment was atrophic and the remaining liver underwent compensatory hypertrophy. Histologic examination revealed that the targeted portal veins were coagulated, the endothelium were degenerated and the local hepatocytes were necrotic after embolization. (4) In the rats with implanted liver tumor, the affected segment including the tumor was necrotic and atrophic. The tumors were completely necrotic, and no viable tumor cell was seen under microscope in 12 among the 15 rats. Three tumors 10 mm in diameter were not completely necrotic. Part of tumor cells were still alive and infiltrated into the surrounding liver. Conclusion SPVE with ethanol is effective in the treatment of small liver tumor in rats. However,in case of bigger tumors involving several segments, SPVE should be combined with other treatment.

Objective To evaluate the effects of percutaneous computed tomography-guided ethanol injection (PEI-CT) in adrenal benign functioning tumors. Methods Twenty cases of adrenal benign functioning tumors were treated by the therapy of PEI-CT. Among them, 5 cases were pheochromocytomas, and 15 cases were aldosteronomas. After the treatment, the change of blood pressure, aldosterone plasma levels, potassium plasma levels, and catecholamines urine levels was investigated. Both plain and enhanced CT scans were performed before and after the treatment to evaluate the changes of the size and necrosis in the tumors. Results Normalization of blood pressure and catecholamines urine levels was observed in 5 cases of pheochromocytoma during 6-19 months′ follow up after the treatment. In the 15 cases of aldosteronoma, aldosterone plasma levels reduced with potassium plasma levels increasing to the normal range within 5-7 days after the treatment. Aldosterone plasma levels increased with potassium plasma levels reduced again in 7 months after the treatment in one case, aldosterone plasma levels and potassium plasma levels returned to the normal range after the second treatment. Hypertension returned to normal in 13 cases of aldosteronoma, and one case maintained normal blood pressure (BP) only under the condition of taking lower dosage of spironolactone within 7-15 days after the treatment, and one month later, the blood pressure of the case become normal without taking any antihypertensive drugs. The other case maintained normal blood pressure in the need of taking lower dosage of antihypertensives after the treatment. CT scan showed total necrosis of tumors in 15 cases and majority necrosis in 5 case within 7-15 days after the treatment. Conclusion The therapy of percutaneous computed tomography-guided ethanol injection in adrenal benign functioning tumors shows satisfactory effects with the advantages of easy manipulation, safety, less injury and cost.